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While economic crises can increase socio-economic disparities in health, little is known about the impact of the 2008–09 Great Recession on obesity prevalence among children, especially low-income children. The present study examined whether socio-economic disparities in obesity among children of pre-school age participating in a federal nutrition assistance programme have changed since the recession.
A pre–post observational study using administrative data of pre-school-aged programme participants from 2003 to 2014. Logistic regression was used to examine whether the relationship between obesity prevalence (BMI≥95th percentile of the Centers for Disease Control and Prevention’s growth charts) and three measures of socio-economic status (household income, household educational attainment, neighbourhood-level median household income) changed after the recession by examining the interaction between each socio-economic status measure and a 5-year time-period variable (2003–07 v. 2010–14), stratified by child’s age and adjusted for child’s sociodemographic characteristics.
Los Angeles County, California, USA.
Children aged 2–4 years (n 1 637 788) participating in the Special Supplemental Nutrition Program for Women, Infants, and Children.
The magnitude of the association of household income and household education with obesity increased after 2008–09 among 3- and 4-year-olds and 2- and 3-year-olds, respectively. However, the magnitude of the association of neighbourhood-level median household income with obesity did not change after 2008–09.
Disparities in obesity by household-level socio-economic status widened after the recession, while disparities by neighbourhood-level socio-economic status remained the same. The widening household-level socio-economic disparities suggest that obesity prevention efforts should target the most vulnerable low-income children.
We identify characteristics of local health departments, which enhance collaborations with community- and faith-based organizations (CFBOs) for emergency preparedness and response.
Online survey data were collected from a sample of 273 disaster preparedness coordinators working at local health departments across the United States between August and December 2011.
Using multiple linear regression models, we found that perceptions of CFBO trust were associated with more successful partnership planning (β=0.63; P=0.02) and capacity building (β=0.61; P=0.01). Employee layoffs in the past 3 years (β=0.41; P=0.001) and urban location (β=0.41; P=0.005) were positively associated with higher ratings of resource sharing between health agencies and CFBOs. Having 1-3 full-time employees increased the ratings of success in communication and outreach activities compared with health departments having less than 1 full-time employee (β=0.33; P=0.05). Positive attitudes toward CFBOs also enhanced communication and outreach (β=0.16; P=0.03).
Staff-capacity factors are important for quick dissemination of information and resources needed to address emerging threats. Building the trust of CFBOs can help address large-scale disasters by improving the success of more involved activities that integrate the CFBO into emergency plans and operations of the health department and that better align with federal-funding performance measures. (Disaster Med Public Health Preparedness. 2018;12:57–66)
Investments have been made to alter the food environment of neighbourhoods that have a disproportionate number of unhealthy food venues. Corner store conversions are one strategy to increase access to fruits and vegetables (F&V). Although the literature shows modest success, the effectiveness of these interventions remains equivocal. The present paper reports on the evaluation of Proyecto MercadoFRESCO, a corner store conversion intervention in two Latino communities.
A repeated cross-sectional design was employed. Data were stratified by intervention arm and bivariate tests assessed changes over time. Logistic and multiple regression models with intervention arm, time and the interaction of intervention and time were conducted. Supplementary analyses account for clustering of patrons within stores and staggering of store conversions.
Three stores were converted and five stores served as comparisons in East Los Angeles and Boyle Heights, California, USA.
Store patrons were interviewed before (n550) and after (n407) the intervention.
Relative to patrons of comparison stores, patrons of intervention stores demonstrated more favourable perceptions of corner stores and increased purchasing of F&V during that store visit. Changes were not detected in store patronage, percentage of weekly dollars spent on food for F&V or daily consumption of F&V.
Consistent with some extant food environment literature, findings demonstrate limited effects. Investments should be made in multilevel, comprehensive interventions that target a variety retail food outlets rather than focusing on corner stores exclusively. Complementary policies limiting the availability, affordability and marketing of energy-dense, nutrient-poor foods should also be pursued.
Weight self-perceptions, or how a person perceives his/her weight status, may affect weight outcomes. We use nationally representative data from 1988–1994 and 1999–2008 to examine racial/ethnic disparities in weight self-perceptions and understand how disparities have changed over time.
Using data from two time periods, 1988–1994 and 1999–2008, we calculated descriptive statistics, multivariate logistic regression models and predicted probabilities to examine trends in weight self-perceptions among Whites, Blacks, US-born Mexican Americans and Mexican immigrants to the USA.
National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and continuous NHANES (1999–2008).
Adult NHANES participants aged 18 years and older (n 37 050).
The likelihood of self-classifying as overweight declined between 1988–1994 and 1999–2008 among all US adults, despite significant increases in mean BMI and overweight prevalence. Trends in weight self-perceptions varied by gender and between racial/ethnic groups. Whites in both time periods were more likely than racial/ethnic minorities to perceive themselves as overweight. After adjustment for other factors, disparities in weight self-perceptions between Whites and Blacks of both genders grew between survey periods (P<0·05), but differences between overweight White women and Mexican immigrants decreased (P<0·05).
Weight self-perceptions have changed during the obesity epidemic in the USA, but changes have not been consistent across racial/ethnic groups. Secular declines in the likelihood of self-classifying as overweight, particularly among Blacks, are troubling because weight self-perceptions may affect weight-loss efforts and obesity outcomes.
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